Monthly Archives: July 2016

Special dermatologic needs for men who have sex with men

2016-07-29

Kenneth A. Katz, M.D., M.Sc., M.S.C.E., a dermatologist in San Francisco, occasionally finds himself asking male patients about their sex lives: Do they have intercourse with men? What about multiple partners? Condom use?

He has both their skin health and their overall health in mind. According to him, men who have sex with men—a category that includes gay and bisexual men—face unique risks of skin conditions because they’re more likely to suffer from HIV and other sexually transmitted diseases.

“Sexual orientation doesn’t put someone at risk,” he tells Dermatology Times in an interview prior to making a presentation at the summer meeting of the American Academy of Dermatology in Boston. “But behavior linked to these conditions does.”

Dr. Katz is presenting “Taking Care of Gay Men and Other Men Who Have Sex with Men: What the Dermatologist Needs to Know.”

“Dermatologists should appreciate that men who have sex with men are at higher risk of HIV and other sexually transmitted diseases,” he says. According to him, more than 80% of 20,000 syphilis cases in the United States were in gay and bisexual men, as were 75% of 45,000 new HIV cases.

These men also face higher risks of skin cancer, MRSA and meningococcemia, a rare bacterial infection. Earlier this summer, health officials reported an outbreak of meningococcemia in Southern California among gay and bisexual men; one man died. Other outbreaks have been reported over the past two years in the Chicago, Los Angeles and New York City areas.

Dr. Katz urges dermatologists to look for these signs that could indicate sexually transmitted diseases:

Rashes or sores in the genital and perineal areas are a possible sign of syphilis or meningococcemia. In addition, he says, “a full body rash can be a manifestation of acute HIV infection and is a hallmark of secondary syphilis.”

Purpuric lesions, non-blanching spots of blood that escaped the blood vessels under the skin, can be a sign of meningococcemia, among other diseases.

Spots on the soles and palms are a hallmark of secondary syphilis.

How can a dermatologist sensitively bring up a patient’s sexual history when his or her condition suggests a possible link to an STD?

Dr. Katz says something like this: “I ask all my patients with a rash like yours some sensitive questions about their sexual history because it’s important to my care for you. Is that OK with you?”

If the patient agrees, he says, “then I’ll ask in a straightforward and nonjudgmental way: Are you sexually active? What are the genders of your sex partner or partners? What’s your HIV and sexually transmitted disease status? How frequently do you use condoms during sex? What’s your vaccination history?”

Keep in mind, Dr. Katz says, that gay and bisexual men often haven’t felt comfortable discussing their sexual history with physicians.

Inside the world of male sex workers

The well-dressed father of two earns good money. He speaks English and works for an international NGO that combats HIV/AIDS. He used to be a sex worker, a man who has sex with other men, and then became a government informer, reporting back to the police on other sex workers who were then arrested. He resorted to drink and drugs because of his shame and isolation. And now he wants to talk about it.

The root cause of all his problems, says Ko Kyaw Zayyar Swe, 38, is poverty. He was forced out of school at 15 because his soldier father could not afford the tuition fees. He worked as a waiter at a Chinese restaurant, but the owner cut his already low wages after giving him a dumpling for lunch instead of money. He quit.

Because he never made it to 10th standard, he could not find a good job, and money was always short. When he married at the age of 17, making ends meet became almost impossible.

“I was working in a shop in Bogyoke Market. One day, two foreigners I’d seen before in the market bought me jeans and shirts. Nobody had ever given me anything before,” he said.

The men invited him for drinks, then brought him back to their hotel room and asked for sex.

“I was shocked. But I needed money urgently for my family so I agreed to do it,” he said.

More contacts were made, and more money came in. He became a regular sex worker, offering services for gay men. Since foreigners paid much better than local men, Ko Kyaw Zayyar Swe decided to learn English.

He came to know many other male sex-workers like himself, working around Bogyoke and Theingyi Zay markets and Sule Pagoda Road, and even further afield.

In 2003 he was arrested under a law banning “inappropriate” sex, along with a friend and two foreigners, and spent two-and-a-half years in Insein Prison. The law is also used against transgender people.

This was the first time his parents and his wife became aware of his secret life.

When he was released, the Ministry of Home Affairs asked him to turn informer against the male prostitutes of Yangon. As his friends went to prison, he got paid. “I received K10,000 a day for some years. That was a lot of money. I didn’t want to destroy other people’s lives because I knew what it was like to be in that position. In the end, I stopped informing and went back to being a sex worker myself,” he said.

All the other sex workers did what they did because they were poor, he said, and saw no other way out. “We didn’t dream of this profession. But with no education and no work but odd jobs, how can you support a family? We didn’t want to be rich. We just wanted enough to get by for a family life.”

Conditions for sex workers changed with the advance of the internet. Now they don’t have to hang around on the street, but make contact online through dedicated websites. At one time, you could see up to 50 sex workers around the markets at night, chatting to customers. There is a thriving market for male sex-workers among gay men, with more male than female customers.

Though the money is the best they have ever made, male sex-workers feel disgusted, lonely and depressed. They feel nobody stands up for their rights, and everybody looks down on them.

“This way of life makes us angry. We can’t share our feelings with family or friends. It’s a big problem for society too,” said Ko Kyaw Zayyar Swe.

Many drink to forget, he said, and then go on to take drugs.

One day, a man from Bangladesh involved in promoting health awareness for male sex-workers asked him to take a part-time job at his NGO, which was gathering information about prostitution and developing training programs for public health professionals.

Ko Kyaw Zayyar Swe said sex workers needed both physical and mental support, as well as job opportunities, to be provided by the government, NGOs and INGOs.

“I never even knew how to use a condom with customers. Luckily, I didn’t get HIV. Knowledge is very important and we need that,” he said, adding that courses in leadership skills, empowerment and capacity building would also help to raise self-confidence.

Dr Aung Myo Min, director of Equality Myanmar Human Rights Group, said male sex workers were hard to reach because they isolated themselves. Too much isolation, he warned, could turn them into drug addicts, or even susceptible to becoming terrorists.

“They are ashamed of what they do. They only do it for the money. Even within the group, there are problems of competition for customers,” he said.

They are not even particularly high-profile. Most of the small counselling groups set up by NGOs in Myanmar for HIV and health awareness cater to female and transgender prostitutes because most of them suffer exploitation, discrimination and even torture. Male sex-workers are seen as being in the profession mainly for the money.

“Even their customers can find them difficult to deal with because of their lack of self-esteem and feelings of indignity. There has to be a way of allowing them to change their profession,” said Dr Aung Myo Min.

A doctor who provides health support for people living with HIV and AIDS said male sex-workers are particularly difficult to contact. “Both sex-workers and customers have to be aware of sexual health issues. Now there are many drop-in centres, including day-care centres for HIV-positive patients, where they can express their feelings and receive support,” said the doctor.

According to 2013 figures from the UN agency UNAIDS, there are an estimated 70,000 sex workers in Myanmar. About 8 percent of them are living with HIV.

“Their health problems or society’s ageist stereotypes that portray seniors as asexual were not going to become excuses to give up on life – or sex.”

She revealed how many older people surveyed were inspired to explore their sexuality more and try new ways to spice up their love lives.

Last year, research by The University of Manchester told how more than half of men and a third of women over 70 in England are still sexually active.

In online chats, many revealed the ‘ageist stereotypes’ they faced, with some telling how their concerns about sexual health were dismissed by doctors.

Similarly they were met with disapproval from their children if they were candid about their sex lives.

Popular discussions online included dating advice, continuing a sex life after a bereavement and new sexual relationships.

Despite being happy to swap anecdotes online, some were embarrassed to try sex tips or aids in their own lives – for fear of judgement.

The report concluded that older people who accepted their physical imitation and adopted accordingly continued to enjoy a healthy sex life.

While many admitted they were happy to abstain, advertising for sex enhancements featuring younger models was a focal reason for problems in the bedroom.

Prof Berdychevsky said: “These stereotypes caused performance anxiety in some older men and some older women believed that both partners should have a say in whether sex enhancement drugs are prescribed.”

Diet, Substance Abuse and Male Fertility

2016-07-25

Recently, the American Society for Reproductive Medicine held their annual meeting in Honolulu, Hawaii. The topic of male fertility, in terms of diet and substance use, came up. Recent studies have found conflicts which leave specialists scratching their heads. But endocrinology and andrology experts say observational studies alone are not significant. Though in vitro fertilization (IVF) is better overall for those men who consume more fruits and vegetables, one study showed that eating produce with a high amount of insecticide residue affected sperm quality. But another study showed that vegetarians tended to have poorer sperm concentrations than omnivores. Another paper found that tobacco smokers have a higher risk of erectile dysfunction. But those who drank alcohol were less likely to experience it. Urologists often tell men to stay away from alcohol when trying to conceive. Yet, the final study showed that those men who had a high caffeine intake had more trouble conceiving, while male alcohol consumption seemed to increase chances.

The University of Illinois at Chicago’s Craig S. Niederberger, MD said, “While the results of some studies presented at the meeting seem to be contradictory, it is important to remember that observational studies often can’t tell the whole truth.” He went on, “A more rigorous scientific approach would include randomly assigning people to diets—what scientists call prospective randomization—and seeing what happens.” He added, “So we’re left with a basic rule of thumb: if it’s healthy for other parts of the body, it’s probably good for reproduction, too.” President of the American Society for Reproductive Medicine (ASRM) Rebecca Z. Sokol, MD, MPH said, “The human organism is complex and substances we inhale and imbibe have systemic effects beyond the stimulation the user is seeking.” She went on, “These studies provide new information that can help men make healthy choices for themselves, their partners, and their future children.”

Foreplay Techniques She’ll Crave

Men are ready at the flip of a switch. Women however take some time to get in the mood both physically and psychologically. As a guy it’s your job to warm up her engine. Foreplay isn’t always easy. It takes time, patience and forethought to pull off right. Of course it all depends on what mood she’s in, what she’s doing, if it’s a good time. Women are complicated. What you need to do is strike at the right time. Not when she’s first come in the door from work, but after supper, say when you’re getting cozy on the couch. But that’s not enough. You also need the right approach. Here are some foreplay techniques that she will crave, upping your chances of success, and making it a wild ride. Remember how hot it was to make out on the couch as teenagers? Why does that have to end? Don’t try to take her clothes off just yet. Don’t let the pressure of sex weigh on her. Instead take some time. Tease her and let her feel how excited she makes you. What really turns a woman on is being desired. If you can make her feel how much you want her, she’ll want you back. Keep ramping it up and she’ll want you so bad.

Why not sext with her earlier in the day? Don’t outline every detail. Instead, add in a little mystery. Let her imagination start to work. Remember that some women don’t like it if you are too graphic. Err on the side of subtlety. The mind is where it all begins. So if you can, get her all riled up before she even gets home, if she’s turned on when she comes to see you, half the battle is already won. And who doesn’t like it when a turned on female shows up at your door? If you are out and about together, do secret naughty things to her. That will get her so turned on. Slip your hand up her shirt when sitting in a darkened theater. Work your hand up her thigh at the coffee house. Play footsie under the table when out at the bar with friends. Pull her into darkened corners and kiss her passionately. When you’re at a show or concert, slip your hand down her pants and play with her a little. Chances are you’ll be driving to a secluded spot or jumping right in the back seat because neither one of you can wait until you get home. The number one rule in foreplay is to take your time. Think of foreplay as enjoying the courses to a fine meal. Don’t rush through the appetizer and main course just to get to dessert. Savor each and every course. She’ll be quivering in your arms if you are passionately touching and kissing her all over. With dirty talk, remember a little goes a long way. Compliment her then say something naughty in a low and sexy tone. Whisper it breathlessly in her ear and she’ll be all over you.

Drinks that Increase or Dampen your Sex Drive

When it comes time to order a drink, do you ever consider your sex life in the decision? Most men don’t. But what’s in your cup may be ramping up your libido or killing it. Lots of times when we have a drink, we never even consider how it will affect our sex drive. But believe it or not, what’s filling your glass may give you a boost or hinder your desire, even your ability to perform. Here are some drinks that increase your sex drive and others that dampen it. A lot of guys use booze to loosen up, shake off the jitters and get into the mood. But in fact, it can have the opposite effect, making you too sluggish to “get-it-on.” One or two drinks might be okay, but any more than that and you are risking a night of celibacy. For those who have functioning issues, perhaps skip the alcohol altogether. Whatever you do, don’t have a gin and tonic. Quinine, the active ingredient in tonic, was shown to lower testosterone in one German study.

The cooler months bring with them a delicious treat, apple cider. Try it warm with some cinnamon and cloves. Cinnamon is a proven libido booster for men, and cloves give the reproductive system an overall boost. Some guys are soda guys. No matter where they go, they always order a cola. But all of that sugar isn’t good for your waistline. Extra body fat sucks up testosterone, lowering your sex drive and functionality. For those who opt for diet soda, look out for the artificial sweetener, aspartame. This has been proven to lower sex drive. Why not sweeten some lemon seltzer or fresh iced tea with honey instead? Honey aids in the production of testosterone and so helps stoke the fires of desire. Try honey in ginseng tea. Ginseng was shown in one South Korean study to go so far as to reverse ED. Now that you know, you can select a beverage that will get your engine running, instead of having one that revs but never starts.

The new secret to losing weight? Water

2016-07-21

By Sandee LaMotte, CNN

Suddenly starving? Try drinking some water.

That recommendation isn’t new — but it suddenly got some serious evidence to back it up. A study of nearly 10,000 adults ages 18 to 64 shows that staying hydrated by drinking water and eating more water-loaded fruits and vegetables could help with weight management, especially if you’re overweight or obese.

“Staying hydrated is good for you no matter what, and our study suggests it may also be linked to maintaining a healthy weight,” said lead author Dr. Tammy Chang, an assistant professor in the department of family medicine at the University of Michigan Medical School. “Our findings suggest that hydration may deserve more attention when thinking about addressing obesity on a population level.”

Being dehydrated can mess with your mental, physical and emotional health. Numerous studies show attention, memory and mood can be damaged, and physical distress such as headaches, constipation and kidney problems can result.

But when it came to weight loss and gain, the science on the role of water has been murky. Some studies found drinking water helped control weight gain, yet other studies showed the opposite. Part of the problem, said Chang, was the way hydration has been measured.

“Water consumption is not an ideal measure of hydration,” explained Chang. “The amount of water it takes to stay hydrated depends on your body size and many other factors like your activity level and the climate you live in. Imagine if you were a landscaper in Arizona versus a receptionist in Michigan. The amount of water it takes to stay hydrated will be drastically different.”

Some need more water to stay hydrated

Chang and her fellow researchers at the University of Michigan looked at the topic in a new way — not how much water you drink, but how well hydrated you are when you do so. To do that, they measured the concentration of water in urine.

They found that staying hydrated — which helps your heart pump blood more efficiently to your muscles, which then makes them work more efficiently — was especially important for anyone with a body mass index (BMI) over 25, which is technically overweight and unfortunately applies to all too many of us. In fact, two out of every three Americans are overweight or obese.

“We found hydration and BMI/obesity are associated,” said Chang. “A bigger person needs more water than a smaller person to stay hydrated.”

“It could be that those people with higher BMI are more likely to be inadequately hydrated or that those that stay well hydrated are less likely to be obese.”

Signs you need more fluids

More research is needed, said Chang. But in the meantime, here are ways you can find out if your body has enough fluids.

“Feeling thirsty is the most straight forward way to know if your body needs more water,” said Chang. “Your mouth may feel dry. You may feel run down or less alert. However, I have found that my patients often confuse these symptoms with other urges like hunger or general fatigue.”

The color of your urine is another good way to tell. If your urine is light yellow, almost the color of water, you’re in good shape. If your urine is dark yellow, it’s time to drink up.

And yes, water is best. “Other beverages come with other substances like sugar in soda, or caffeine in coffee that are not recommended in large amounts,” said Chang. “Soft drinks typically contain sugar or chemical sugar substitutes that I do not recommend to my patients. Water is the best for hydration for most people.”

Worried About ED? Look at Your Diet

Lots of things can cause erectile dysfunction. But the most common is the onset of heart disease. In this case, ED is generally brought on by a poor diet and lack of exercise. Foods high in fat, sugar, and cholesterol add to the buildup of plaque on artery walls.

Since the arteries that supply the penis with blood and create an erection are much smaller than those in other parts of the body, they tend to clog up first, which is why physicians count ED as an early symptom to a more pressing problem. If left unchecked, it could lead to a heart attack or stroke. Too much sugar in the diet, along with a lack of exercise and being obese, can also lead to type 2 diabetes. If left uncontrolled, the elevated sugar level can damage nerves and tissues, including the nerves which cause an erection. So diet can lead to ED in that sense as well.

Obesity may also cause a lack of testosterone. This is a crucial hormone for the sex drive and erection formation. Fat cells trap testosterone. But the body does not make more, thinking that there is enough in the system. In this way, a high fat diet can also affect male fertility, as a certain level of testosterone is required for proper sperm production. One’s diet should consist mostly of fruits and vegetables.

When you look at your plate, two-thirds of it should be from produce. Lean proteins such as chicken or fish, and whole grains are also important, and should make up the other third. Red meat and high fat or high caloric foods can be eaten occasionally, red meat just once per week. But the majority of one’s diet should be healthful. With the right diet and cardiovascular exercise, most of the time, ED can be avoided. If you are already experiencing the condition, be sure to talk to a doctor or urologist. A serious medical condition could be causing it. Take heart. There are also many treatment options. One is sure to help you.

Hyperfocus: The other side of adult ADHD

2016-07-18

Writers, entrepreneurs, and creative leaders of all types know that intense focus that happens when you’re “in the zone”: You’re feeling empowered, productive, and engaged. Psychologists might call this flow, the experience of zeroing in so closely on some activity that you lose yourself in it. And this immersive state, as it turns out, also happens to be something that some adults with ADHD commonly experience.

It sounds like a contradiction in terms: You think ADHD and you think of a spaced-out, scattered kid, right? But by definition, ADHD is a “maldistribution” of attention — that is, people who have it often oscillate between splintered and hyperfocused attention. The latter is what Brandon Ashinoff, a psychologist at the University of Birmingham who studies hyperfocus, has called an “interesting paradox” — it’s too much focus, as opposed to a scattered attention span. “You’re focused so intently on something, no other information gets into your brain,” Ashinoff has said.

In other words, ADHD shows up in different ways depending on the person; the goal is to help people regulate their attention and harness the kind of attention necessary for the task at hand. (And recent research from Brazil and King’s College London, by the way, has suggested that despite its reputation as a childhood problem, it’s more common than you might think for the condition to show up for the first time in adulthood, even among people who never showed signs of it in childhood.) Generally speaking, ADHD is classified into two broad categories: inattentive type, and hyperactive/impulsive type. Hyperfocus is seen among both of these types — and yet it’s been largely neglected in academic research.

That’s surprising, especially considering the significant impact — both positive and negative — hyperfocus can have at work and at home. Hyperfocus is great for engaging in longer tasks which require intense concentration — but it’s not so great if that means that the more mundane tasks, chores, and assignments fall by the wayside. When composing a song or coding a new program, the tendency to lose sight of all else proves beneficial; when failing to get laundry or dishes done for days on end, the tendency becomes a potential problem.

One of the few pieces of research on the hyperfocus piece of ADHD is from South Africa, and was the subject of a University of Johannesburg master’s thesis by researcher and writer Rony Sklar — indeed, much of her work has raised the question of why hyperfocus isn’t being looked at in the literature, since her own work was limited by sample size. “The field is wide open and people really need to start researching it,” Sklar told Science of Us. “It’s not about having an attention deficit, it’s more a maldistribution of attention. It’s not about not being able to concentrate; it’s about being able to concentrate in different forms and different intensity.” Put another way, there is a spectrum along which attention gets channeled for human beings; those diagnosed with ADHD don’t have less attention than normal — it’s more accurate to say that their attention can be splintered or hyperfocused, or it can swing between the two. Their challenge is to learn ways to distribute their attention more evenly, by regulating it or even manipulating it to serve their purposes according to the task at hand, often through the use of practical tools like timers, calendars, reminders, alarms, and breaking tasks into concrete steps.

In Sklar’s limited research, she’s found that people with ADHD tend to use less mental effort to play a computer game than people without ADHD, “which could mean that they entered the flow state more readily than the non-ADHD group,” says Sklar. Additionally, the ADHD group had higher activation in the parietal lobe, which is notable because most studies have found that ADHD individuals have lower parietal lobe activation. This makes sense if you think about it — under normal day-to-day circumstances where shifting attention is required, the ADHD individual may struggle; the usual lower activation in the parietal lobe of those with ADHD is thought to be linked to impaired attention. But in Sklar’s sample, where people were intensely focused — or in a state of “hyperfocus” — those with ADHD had higher parietal lobe activation than the non-ADHD group, which “could support the idea of people with ADHD being able to sustain attention depending on the specific context,” says Sklar. So this could suggest something rather exciting: that ADHD individuals have, at least in some contexts, a leg up over non-ADHD folks, in that ADHD in fact helps people sustain attention for longer periods than normal in some situations. Under the right conditions, hyperfocus is ADHD’s secret superpower.

For a child or adult with ADHD, the determining variable is interest — if the person loves to play music, they can do it for hours. If they hate doing dishes, they will clean one dish, lose focus, and jump to another activity. One metaphor that captivated Sklar’s attention paints an interesting picture — first put forth by author Thom Hartmann, the theory suggests that those with ADHD have more of a “hunter” orientation, evolutionarily speaking, and those without ADHD are the “farmers.” One group is more nomadic and needs to constantly scan the environment, with attention darting here and there for prey; the other group possesses the patience, calm, and nurturing ability to tend to repeated farming tasks with long-term consistency. The hunter mindset in some ways explains hyperfocus — once the prey is identified, the hunter intensely focuses on her pursuit.

But Arthur Caye, the lead researcher in Brazil’s recent study, asserts that hyperfocus may be a result of overcompensating: that is, people who have ADHD may tend to zero in on one particular pursuit as a way to make up for the distractedness in other areas. So it may not be that hyperfocus is a clinical symptom of ADHD — and, indeed, hyperfocus is not listed in the DSM-5 — but it could be a response to having the condition, according to Caye, and it can be channeled into productive or unproductive pursuits. Hyperfocus is not a common topic of conversation among researchers, including Caye and his counterparts at King’s College London, but it is among those with ADHD and their therapists and coaches.

This narrative sounds familiar to Maria Yagoda, a writer and Yale graduate who has ADHD. “I will definitely get sucked into something and have to devote all my time and energy into that,” Yagoda told Science of Us. She has written previously for The Atlantic about how the condition affects her and how people are often surprised that someone like her — a successful Ivy League graduate — could have ADHD. “Sometimes on days that are the craziest — different news stories breaking, too many meetings, family drama — I’m able to focus more intensely than I could on a normal day. I feel like I kick into this special productivity gear.”

Yagoda is an adult female with ADHD — an overlooked demographic in treatment and research circles — and yet the positive and negative symptoms of ADHD for her resemble what many other individuals with ADHD experience, regardless of age or gender.

Specifically with regard to hyperfocus, says Yagoda, “It’s like when I worked at a sandwich shop — during the lunch rush, I was a total beast. Slicing meats, throwing baguettes around, squeezing mayonnaise — I just got into a zone. Instead of being overwhelmed — which is really easy for me to be — all the pressure and stimulation helped me focus. I was great at it,” says Yagoda.

Borrowing Hartmann’s evolutionary metaphor, one could say that a chaotic newsroom is Yagoda’s “hunting” ground — she has to field fast-paced input when adrenaline-inducing news events happen around her, mentally scan her environment, and prioritize her stories of prey according to a hierarchy that is not based on size of the “kill” but the urgency of the story.

Sklar echoes this description — she says that many people with ADHD actually thrive in a more urgent environment where hyperfocus gives the person an advantage in terms of homing in on what’s important. This sentiment has also been expressed by high-profile people with ADHD, such as soccer star Tim Howard or musician Adam Levine of Maroon 5, who both say the energy of ADHD helps them perform at their job.

There are downsides to a tendency to hyperfocus on things, too, of course. Some people get lost in video games or TV shows and have trouble switching their attention to more pressing tasks. But for Yagoda, in particular, that has not been the case, and hyperfocus does not stand out as an impediment. “It’s a new thing for me to think about it as a strength,” she admits. “That’s a revelation.”

So far, the anecdotal evidence from stories like these is clear — the supporting data, alas, is not, namely because there is not yet enough of it. Sklar, for one, is hoping that changes. She receives regular contact from those in the ADHD community, particularly from coaches and therapists, who say that her conclusions are spot-on as evidenced by working with individuals who experience hyperfocus. And Sklar says that she is confident that research is heading in the right direction and that more people are taking note. “This is where the research is going and where it needs to go,” she says. “Hyperfocus can be very powerful. My hope is that people can become the best versions of themselves using the tendency.”

Screen violence — real and fictional — harmful for kids, experts say

Those are just some of the things that children see when they view news coverage of violent events, such as thetruck attack in Nice, France, on Thursday.

Screen violence — which includes violence in video games, television shows and movies — is associated with aggressive behavior, aggressive thoughts and angry feelings in children, according to a policy statement released by the American Academy of Pediatrics early Monday.

“Screen violence, particularly when it is real but even if it is virtual, is quite traumatic for children regardless of age,” said Dr. Dimitri Christakis, director of the Center for Child Health, Behavior and Development at Seattle Children’s Research Institute and lead author of the statement.

“It is not uncommon to see increases in nightmares, sleep disturbances and increased general anxiety in the wake of these events. While it is true that the horrific events of this past week can happen at any time, the real risk to individuals remains low,” he said. “Children need [that] reassurance.”

For the statement, which was published in the journal Pediatrics, Christakis and colleagues reviewed and summarized more than a dozen studies and meta-analyses about the effects of virtual violence and aggression on children’s attitudes and behaviors. They defined virtual violence as forms of violence experienced or witnessed virtually on a screen.

After the review, the statement authors made specific recommendations for doctors, parents, the media industry and policy makers to better prohibit easy access to violent media for young children.

“Parents should be mindful of their children’s media diet and reduce virtual violence especially if their child shows any aggressive tendencies,” Christakis said.

During a time of much conflict in the news, Christakis advises parents to reassure their children that there are still mostly good people in the world. He recommends that parents show children stories of people helping each other, and not hurting each other.

“We have done research showing that such eventsfrighten children,” said Brad Bushman, professor of communication and psychology at Ohio State University, who was not involved in the new statement.

The statement authors also called for the federal government to oversee the development of its own media rating system, rather than relying on the entertainment industry’s rating of violent content in video games, movies and television.

“We know from hundreds of studies on thousands of children that there is a link between ‘virtual violence’ and real-world aggression,” Christakis said. “On average, the effect is in what we would deem the small to moderate range, but equivalent to the link between passive smoke exposure and lung cancer — something that municipalities have reacted to by enacting non-smoking ordinances.”

Christakis is quick to point out that there are benefits when children consume nonviolent media. For instance, he led a 2013 study that found that prosocial and educational screen time — including television and video games — can significantly enhance social and emotional competence in children.

What do other scientists think of the new statement? Dr. Douglas Gentile, a professor of psychology at Iowa State University who has studied screen time and children, said the new statement suggests that often it’s not the quantity of media but the quality that can influence aggression in children.

“Often, there are people who like to take extreme positions. Either the studies show games are creating a generation of shooters, which the science does not support, or they say there is no evidence that there are harmful effects, which the science also doesn’t support,” Gentile said.

“It is important to have our public health organizations do these types of reviews so the public can cut through all of that opinion out there,” he said. “Everyone has an opinion, but not all opinions are supported by the science.”